Published online Jan 16, 2014. doi: 10.4253/wjge.v6.i1.1
Revised: December 4, 2013
Accepted: December 17, 2013
Published online: January 16, 2014
Peroral cholangioscopy is an important tool for diagnosis and treatment of various biliary disorders. Peroral cholangioscopy can be performed by using a dedicated cholangioscope that is advanced through the accessory channel of a duodenoscope, or by direct insertion of a small-diameter endoscope into the bile duct. Direct peroral cholangioscopy refers to insertion of an ultraslim endoscope directly into the bile duct for visualization of the biliary mucosa and lumen. This approach provides a valuable and economic solution for diagnostic and therapeutic applications in the biliary tree. Compared to ductoscopy using a dedicated cholangioscope, the direct approach has several advantages and disadvantages. In this editorial, I discuss the advantages, disadvantages, and possible future developments pertaining to direct peroral cholangioscopy.
Core tip: Direct peroral cholangioscopy is a valuable and economic tool for diagnostic and therapeutic applications in the biliary tree. However, solutions are needed to make access to the biliary tree easier, and to improve the endoscope stability within the biliary tree for diagnostic and therapeutic maneuvers.